Provider Demographics
NPI:1689626426
Name:MAGUIRE, ANN M (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:M
Last Name:MAGUIRE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:840 N 87TH ST
Mailing Address - Street 2:SARGEANT HEALTH CENTER
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53226-3586
Mailing Address - Country:US
Mailing Address - Phone:414-805-5540
Mailing Address - Fax:414-805-7878
Practice Address - Street 1:840 N 87TH ST
Practice Address - Street 2:SARGEANT HEALTH CENTER
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53226-3586
Practice Address - Country:US
Practice Address - Phone:414-805-5540
Practice Address - Fax:414-805-7878
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2014-05-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI39910207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI1689626426Medicaid
002806261SOtherHUMANA
WI028N73601Medicare PIN
F63365Medicare UPIN